Acute Coronary Syndrome/mortality

IJCS

Editorial

Risk Scores in Acute Coronary Syndrome: Current Applications and Future Perspectives

Pedro G. M. de Barros e Silva et al. Renato D. Lopes

Editorial referring to the article: Validation of the Grace Risk Score to Predict In-Hospital and 6-Month Post-Discharge Mortality in Patients with Acute Coronary Syndrome

Acute Coronary Syndrome (ACS) is the most common cause of death worldwide. Nevertheless, ACS represents a heterogenous group of diseases, encompassing since low-risk unstable angina (30-day mortality below 1%), until patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock (30-day mortality around 50%). Multivariable prediction models have been developed to classify short-term and long-term risk of these patients (). For patients with the diagnosis of ACS, the TIMI risk score and the Global Registry of Acute Coronary Events (GRACE) score have been largely used in clinical practice; the latter, despite being more complex, has shown better performance as a prognostic tool, including prognostic information not only about the acute phase but also about the risk within six months after the cardiac event.

[…]

Ler artigo completo

IJCS

Original Article

Impact of Periodontal Disease on Late Morbimortality (10 Years) of Pacientes with Acute Coronary Syndrome

Luis Lemos Moras et al. Thamara Angeliny Carvalho Marina Bragheto Oliveira Gabriel Andrey Ricci … Renata Accarini Moacir Fernandes de Godoy

Abstract

Background:

It is known that predisposing factors for periodontal disease (PD) and cardiovascular diseases are similar, just as dissemination of oral flora pathogens can induce the development of cardiovascular diseases, which play a direct role on the morbimortality of patients.

Objective:

To assess the impact of periodontal disease in the presence of acute coronary syndrome on late morbimortality after long-term follow-up of patients (10 years).

Methods:

The historical prospective study of continuous assessment was based on the evaluation of 345 medical records of patients hospitalized for acute coronary syndrome, divided into 3 groups: edentulous, with periodontal disease and without periodontal disease. The patients studied were in the ICU, in 2006, with a clinical picture of acute coronary syndrome submitted to invasive stratification with coronary angiography on the basis of clinical indication and were reassessed over the next 10 years. The qualitative variables were compared using the Chi-square test. Long-term mortality was assessed using the Kaplan-Meier curves, quantified with the hazard ratio (HR) and a confidence interval of 95% and compared through Cox regression. P values of less than or equal to 0.05 were regarded as statistically significant.

Results:

Of the 345 patients, 233 had at least one coronary obstruction greater than or equal to 50%, being the main group for comparison according to the different status of periodontal disease (without periodontal disease, with periodontal disease and edentulous). In this cardiovascular condition, we found a difference in mortality among edentulous patients compared to those free of periodontal disease, with a p = 0.004 and a hazard ratio of 10.496 (95% CI: 4.988-22.089). A significant difference was also noted between edentulous patients and patients with periodontal disease, with a p = 0.0017 and a hazard ratio of 2.512 (95% CI: 1.491-4.234).

Conclusion:

A significant increase in mortality was found according with the progression of periodontal disease, which justifies its classification as an important risk factor for the development of cardiovascular diseases, as well as the need for prevention and treatment of oral diseases.